CAJ | 학술논문

目的评价颈动脉粥样硬化斑块的新生血管与冠状动脉粥样硬化性心脏病（简称冠心病）的关系。方法312例冠心病患者中急性冠状动脉综合征（ACS）患者51例（ACS组），稳定性冠心病（sCAD）患者261例（sCAD组）。采用超声造影技术检测2组患者的颈动脉斑块。供分析的超声声像图参数包括：斑块造影增强强度（A值）、斑块增强强度与颈动脉管腔内增强强度比值、斑块厚度、斑块回声的特点（软斑块、硬斑块、钙化斑块、混合斑块）。结果 ACS组患者斑块厚度平均为（2.6±0.4）mm，sCAD组患者斑块厚度平均为（2.9±0.8）mm，2组患者斑块厚度间差异无统计学意义（t=-1.903，P=0.058）。ACS组43例（84.3%，43/51）为软斑块，8例（15.7%，8/51）为混合斑块，无硬斑块和钙化斑块；sCAD组174例（66.7%，174/261）为软斑块，19例（7.3%，19/261）为硬斑块，16例（6.1%，16/261）为钙化斑块，52例（19.9%，52/261）为混合斑块。ACS组患者软斑块所占比例高于sCAD组，差异有统计学意义（χ2=6.274，P=0.012）。ACS组患者斑块增强强度及其比值分别为（11.3±3.2）dB和0.6±0.2，sCAD组患者斑块增强强度及其比值分别为（8.9±3.3）dB和0.4±0.2，2组比较，差异均有统计学意义（t=7.150、7.419，P均＜0.01）。结论超声造影检查可发现急性冠状动脉综合征患者颈动脉斑块新生血管密度显著高于稳定性冠心病患者，揭示颈动脉斑块新生血管密度与冠心病患者的临床症状紧密相关。
목적평개경동맥죽양경화반괴적신생혈관여관상동맥죽양경화성심장병（간칭관심병）적관계。방법312례관심병환자중급성관상동맥종합정（ACS）환자51례（ACS조），은정성관심병（sCAD）환자261례（sCAD조）。채용초성조영기술검측2조환자적경동맥반괴。공분석적초성성상도삼수포괄：반괴조영증강강도（A치）、반괴증강강도여경동맥관강내증강강도비치、반괴후도、반괴회성적특점（연반괴、경반괴、개화반괴、혼합반괴）。결과 ACS조환자반괴후도평균위（2.6±0.4）mm，sCAD조환자반괴후도평균위（2.9±0.8）mm，2조환자반괴후도간차이무통계학의의（t=-1.903，P=0.058）。ACS조43례（84.3%，43/51）위연반괴，8례（15.7%，8/51）위혼합반괴，무경반괴화개화반괴；sCAD조174례（66.7%，174/261）위연반괴，19례（7.3%，19/261）위경반괴，16례（6.1%，16/261）위개화반괴，52례（19.9%，52/261）위혼합반괴。ACS조환자연반괴소점비례고우sCAD조，차이유통계학의의（χ2=6.274，P=0.012）。ACS조환자반괴증강강도급기비치분별위（11.3±3.2）dB화0.6±0.2，sCAD조환자반괴증강강도급기비치분별위（8.9±3.3）dB화0.4±0.2，2조비교，차이균유통계학의의（t=7.150、7.419，P균＜0.01）。결론초성조영검사가발현급성관상동맥종합정환자경동맥반괴신생혈관밀도현저고우은정성관심병환자，게시경동맥반괴신생혈관밀도여관심병환자적림상증상긴밀상관。
Objective To evaluate the relationship between carotid plaque neovascularization and coronary heart disease using contrast-enhanced ultrasound. Methods We studied carotid plaques in 312 patients with coronary artery disease by contrast-enhanced ultrasound [51 patients with acute coronary syndrome (ACS) and 261 patients with stable coronary artery disease (sCAD) ]. We analyzed sonographic features of each plaque, including the enhancement intensity of plaque (A value), the ratio of plaque to carotid artery lumen in enhancement intensity (Ratio), plaque thickness and plaque echo (soft plaque, hard plaque, mixed plaque, calcified plaque). Results The average thickness of plaque in patients with ACS and in patients with sCAD had no significant difference in statistics [(2.6±0.4) mm vs (2.9±0.8) mm, t=-1.903, P=0.058) ]. The group with ACS:soft plaque 43 (84.3%, 43/51), mixed plaque 8 (15.7%,8/51), no hard plaque and calcified plaque. And the group with sCAD:soft plaque 174 (66.7%,174/261), hard plaque 19 (7.3%,19/261), mixed plaques 16 (6.1%,16/261), calcified plaque 52 (19.9%,52/261). The percentage of soft plaque in the acute coronary syndrome group was significantly higher than that in stable coronary artery disease group (χ2=6.274,P=0.012). The A value and Ratio in patients with ACS were prominently larger than those in patients with sCAD [ (11.3±3.2) vs (8.9±3.3) dB, t=7.150,P<0.01;0.6±0.2 vs 0.4±0.2, t=7.419,P<0.01].Conclusion Carotid artery plaque neovascularization density was significantly higher in patients with ACS than that in patients with sCAD by using contrast-enhanced ultrasound, revealing that the neovascularization density is closely related to clinical symptoms of patients with coronary heart disease.